(July 2002) With HIV/AIDS hindering the ability of schools in some countries to deliver education services, new initiatives are afoot to rescue the sector and turn schools into powerful weapons against an epidemic that killed 3 million people in 2001 and saw 5 million people newly infected with the AIDS-causing virus.1

Some researchers suggest that, on their own, preventive education programs targeting the epidemic provide only a partial response to HIV/AIDS and that the key is to undertake a vigorous push toward quality schooling for all children and equal educational opportunities for girls and boys.

The World Bank, for one, asserts that responses to the HIV/AIDS epidemic have too often been “piecemeal, small-scale, health-focused, and weakly integrated into related efforts.”2 The Bank’s new publication, Education and HIV/AIDS: A Window of Hope, calls for a broad, strategic response to HIV/AIDS that is rooted in education, set within a national context, and involves all sectors of society.

The Bank argues that education efforts can yield major results with pre-pubescent young people — who are often the least likely to have HIV — and with youths 15 to 24 years, a group that accounts for some 60 percent of new HIV infections in many countries.

Specifically, countries are being urged to take seriously the international commitment to achieve universal education goals by 2015. According to the Bank, the combination of “Education for All” along with gender equity goals and targeted HIV preventive education, including reproductive and sexual health information, promises to be the most effective means of stemming the epidemic’s spread.

Others agree that countries’ ability to cope with the epidemic will depend on the extent to which their educational institutions can continue to be essential parts of the society’s infrastructure. Research has shown that better-educated people generally have greater access to information, are more likely to make well-informed decisions, and have better jobs and greater access to resources that can help them to support healthier lives.

For girls, in particular, better education contributes to economic independence, delayed marriage, and greater self-assurance and self-reliance. Women of all ages are more vulnerable than men to HIV infection. Anatomical differences make transmission of the virus through sexual contact far more effective from men to women than vice versa. Girls are especially vulnerable because their genital tract is still not fully mature. Even more significant, though, is the fact that powerlessness and dependency diminish their ability to make healthy decisions.

According to a UNAIDS analysis of studies of 15–19-year-olds in 17 African and four Latin America countries, some kinds of risky behavior did increase with education, but better educated girls tended to have sex later. The reverse was true for boys in many countries. Also, both girls and boys with more education were generally more likely to have casual partners. At the same time, people with more education were more likely to protect themselves by using condoms during sexual intercourse.3

“Education is not a magic pill. But it can boost a young woman’s confidence and teach her ‘life skills,’ equipping her to make her own judgements,” according to UNICEF. “It may enable her to assert her right to choose whom and when she marries and to shift the skewed distribution of power between herself and her husband. Education can also provide vocational skills, potentially increasing her economic power, thus freeing her from dependence on her husband, father or brother.”4

Yet, even as quality education promises to be one of the best preventive responses to HIV/AIDS, the epidemic is having a crippling effect on schools and other education institutions in some countries.

Impact of HIV/AIDS on Education

HIV/AIDS is jeopardizing the supply, demand, and quality of education in some of the hardest hit countries, where teachers and students are dying or leaving school, where orphans are increasing, and where resources for schools are rapidly dwindling.

Research shows that absenteeism is increasing among school staff as infected teachers fall ill or take off to care for sick family members, attend funerals, or mourn the loss of relatives and friends. Deaths of teachers and education administrators also appear to be rising, particularly in sub-Saharan Africa.

As University of Zambia professor M.J. Kelly put it, HIV/AIDS is affecting students, teachers, curriculum content, school budgets, as well as the organization, management, and planning of education. “[The epidemic] is slowly leading to questions about the very nature, purpose, and provision of education,” she said.6

The death of a single teacher affects all the children in the class. Some 860,000 sub-Saharan African children had teachers who died of AIDS-related causes in 1999, according to UNAIDS and the World Health Organization (WHO).7 In Zambia, where an estimated 21.5 percent of people 15 to 49 years old have HIV, more than four teachers died per day in 1998, with the total number of deaths not far from the number of new primary level teachers trained that year.8

Researchers believe that southern Africa’s teachers have higher HIV incidence than the general population because of comparatively high incomes and increased mobility. These teachers often relocate to remote areas because of their jobs. This kind of mobility can mean a wider network of sexual contacts and an increased risk of HIV infection.9 In the Central African Republic, where an estimated 12.9 percent of adults are infected, more than 100 educational institutions were closed by the late 1990s as a result of high teacher loss.10

In addition to the supply of teachers, schools are afflicted by a decline in enrollment. A number of factors contribute to this, including the removal of children — especially girls — from school to care for ailing family members and to assist with domestic, agricultural, or other income-generating activities. Also, enrollment is declining as families find it increasingly difficult to afford expenses related to school and as more and more infants contract HIV during birth or through breastfeeding and die before age 5.11 During 2001, about 3 million children under the age of 15 died of the disease, including 2.6 million in sub-Saharan Africa.

In KwaZulu-Natal province of South Africa, where adult HIV prevalence exceeds 30 percent, researchers found that first grade school enrollment dropped 24 percent in 2000. The declines were steeper among girls than boys, with enrollment for girls dropping by 26 percent, compared with 22 percent for boys.12

An increase in orphans is also affecting the demand for schooling, since many of these children are forced to leave school. In Guatemala, various studies show that at least one-third of AIDS orphans drop out of school.13 As of the end of 2001, an estimated 14 million children under age 15 — 11 million of them in sub-Saharan Africa — had been orphaned by AIDS and were alive.

As resources become increasingly scarce, schools encounter serious constraints. Even with declining enrollment, schools in heavily affected countries are unable to meet the demand for education because of heavy staff losses.14 For many schools, income is declining as costs are rising. Because of AIDS, public spending is increasingly directed away from education and other sectors toward health care.

The Way Forward

In light of the impact on education, countries are now obliged to devise ways of turning the sector against the epidemic. Researchers stress that school systems need to vigorously pursue “Education for All” goals and to find ways to keep girls in school.

Countries have been grappling with these goals for some time. The 1990 World Conference on Education for All in Jomtien, Thailand, pledged to achieve universal primary education by 2000. However, more than 113 million are not enrolled in primary school, a figure that represents one in five of all children 6 to 11 years old. An estimated 60 percent of the total are girls, and 87 percent live in sub-Saharan Africa, South and West Asia, and the Arab States and North Africa.15 Countries set another “Education for All” deadline at their United Nations Millennium Summit in September 2000. The new goal calls for countries to ensure that all children complete a full course of primary schooling by 2015 and that by 2005 both girls and boys have equal access to primary and secondary education.

However, as HIV/AIDS thwarts progress in some areas, the World Bank says the regions at greatest risk of not meeting “Education for All” goals are Africa and South Asia — regions that account for 80 percent of the primary age population that are out of school. Some countries face an even greater challenge in attempting to ensure equal opportunities for girls and boys in primary and secondary school by 2005, since girls are most likely to be the ones to leave school as a result of HIV/AIDS in the home.

In the meantime, school planners are looking at other ways in which the education system can better serve communities ravaged by HIV/AIDS. These include:

Examining alternative forms of schooling. Policymakers are looking into a shift from the age-related grade system to a more flexible schedule that relies on modules and semesters;

Incorporating sexual health and HIV/AIDS education into the classroom for all ages and into programs for children who have left school to support the household or family members;

Ensuring that students are adequately equipped with the relevant life skills — practical skills that help them develop positive social behavior and cope with negative pressures;

Developing special programs that target AIDS orphans and other vulnerable children.

In Zambia, an interactive radio program attempts to provide orphans and other vulnerable children with an education. While in Uganda, The AIDS Support Organization (TASO) is seeking to defray school costs for more than 200 orphans and other vulnerable children attending primary, secondary, and vocational schools. TASO also trains teachers in basic counseling skills and provides a forum for children and their guardians to discuss their problems.

The World Bank recommends that countries obtain resources for achieving their educational goals either from private investors, donors, or through public-sector allocations. Policy reforms aimed at keeping children in school and improving the quality of education may lower the costs of achieving the goals.

The World Bank, Education and HIV/AIDS: A Window of Hope (Washington, DC: World Bank, 2002).

UNAIDS and WHO, AIDS Epidemic Update: 8.

UNAIDS, Report on the Global HIV/AIDS Epidemic: July 2002.

Peter Badcock-Walters, Managing the Impact of HIV/AIDS in Education in KwaZulu Natal: A Presentation to the National Teacher’s Union Advocacy Conference on HIV/AIDS, accessed online at www.und.ac.za/und/heard, on Jan. 25, 2002.